With each new shooting tragedy we struggle as a society how these things can happen. The gun law debates are reignited as are discussions over balancing public safety with individual rights. But, who are these people anyway? The profiles are simpler than you think.

Experts feel the profiles fall into three broad categories which are sociopath (psychopaths), delusional psychotics and the suicidally depressed. Sociopaths are further broken down into those with a genetic brain disorder (reduced amygdala volume with reduced capacity for empathy), childhood trauma victims and “conflicted opportunists” (regular folks in a moral delimma who chose wrong: “There but by the grace of God go I!”) The last is the most intriguing, but least likely. Drugs, particularly stimulants like methamphetamines, are the “X” factor, but usually result in crimes of opportunity and robbery, not mass killings.

Sociopaths can be identified and sometimes mainstreamed (I’ve done this many times) and delusional and suicidal patients are always treatable. Often access to care is an issue, due to lack of resources or weak commitment laws. We most identify with a conflicted individual, because he seems like us, but this is usually not a mass murderer. Religious or moral training has virtually no impact.

Worse, prediction is almost impossible. Mass killers go through great pains to avoid detection. No ready answer looms, but adequate Psychiatric care and appropriate commitment laws are a start.